Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 25MA04953900 | NJ |
NPI | 1003914706 |
---|---|
Provider Name | Dr. Stanislaw Sliwowski |
First Address | Wallington, NJ 07057-1300 |
Second Address | Wallington, NJ 07057-1300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 23/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122620701 | (05) | NJ |
C56906 | (02) | NJ |